Staff wellbeing in Fire Rescue Victoria

Our survey of FRV staff

In January and February 2024, we surveyed FRV staff to understand how FRV supports their mental health.

The survey asked questions about:

• work history
• physical health
• wellbeing
• mental health
• stressful experiences
• suicidal thoughts and behaviours
• work experiences
• workplace culture
• seeking support
• substance use
• demographics.

Approximately 18 per cent of all FRV staff (983 people) at the time responded to the survey. Approximately 28 per cent of all secondees at the time (63 people) at the time responded to the survey.

Previous mental health studies

In 2018 Beyond Blue led a study called Answering the call. It surveyed the mental health and wellbeing of people working in fire and rescue, ambulance, police and state emergency services across Australia. At the time of the survey 33 of the 36 agencies in the sector participated. CFA took part but MFB did not.

In 2021 the University of Western Australia led a study called After the Fires. It surveyed how the 2019–20 Black Summer bushfires impacted fire, rescue and state emergency services staff. Nineteen agencies from across Australia, including CFA, participated but FRV did not.

We compare data from our survey with data from these studies throughout this report.

Mental health support

FRV offers staff a range of mental health support, including services, training and information that promotes awareness about maintaining good mental health. 

Awareness of support

As Figure 1 shows, survey respondents reported strong awareness of these services and training. Overall, secondees reported less awareness. 

We only listed a selection of FRV's mental health and wellbeing services and training in our survey question. This means we do not have data about staff awareness of its other support. 

Figure 1: Proportion of FRV staff who reported they were aware of selected mental health support 

Source: VAGO FRV staff survey.

Secondees' experience of support

Secondees have access to the same services, training and information as other FRV staff, but in our survey they reported less awareness of this support than other staff.  

In 2021 FRV engaged with CFA's organisational wellbeing team and 17 seconded assistant chief fire officers and commanders to: 

• understand the mental health issues that secondees were facing 
• develop an action plan to address these issues.

The action plan had the following objectives:

• increase awareness of the available support services and encourage secondees to seek help where needed
• take proactive steps to help seconded staff maintain positive mental health and wellbeing
• provide best-practice interventions to support recovery.

The plan had 9 actions to achieve these objectives. FRV and CFA have completed or partially completed 8 of these actions. 

FRV told us it is currently working with its secondment management department on 3 projects to improve communication with secondees and support their mental health. 

Mental health training 

FRV provides its staff with a range of mental health training opportunities. It targets training for different stages of a staff member's career.

FRV is drafting a mental health literacy framework to define what its staff and their families need to know about mental health at each stage of a staff member’s career. It also intends to establish a mental health curriculum to train staff to the required level of proficiency. 

We reviewed the spreadsheets FRV uses to manually record attendance at voluntary and mandatory training. We found many of these spreadsheets were missing entries and data for varying time periods. 

We also found FRV does not collect attendance data for some of its training courses, including optional training courses on vicarious trauma, which it offers to corporate staff.

This means FRV cannot accurately confirm how many of its current staff have completed mandatory and/or voluntary training. This limits its: 

• understanding of staff knowledge of mental health
• ability to make strategic decisions about future investments in staff mental health training. 

Information-sharing across FRV

FRV shares information about mental health and wellbeing and its support services through a range of channels and in a variety of formats. For example:

• online via its intranet
• on posters at worksites
• through regular and one-off emails, such as when a staff member has died or when the media has covered a traumatic event involving FRV
• via face-to-face meetings and conversations with support staff.

Of the staff who responded to our survey:

• 49 per cent of non-secondees reported good communication by FRV about mental health safety issues that affect them
• 21 per cent of secondees reported good communication.

Reporting mental health issues 

FRV provides 9 channels that staff can use to report a mental health issue. 

Many of these channels can provide direct support to the staff member seeking support. 

Of the staff who responded to our survey: 

• 82 per cent of non-secondees said they knew where or how to report a mental health issue
• 51 per cent of secondees said they knew where or how to report a mental health issue.

Usefulness of services 

Of the 983 staff who responded to our survey, 232 said they had used FRV's mental health services in the last 12 months.

Most of these staff found the services 'quite' or 'extremely' useful.

We also surveyed staff about 8 other services. But fewer than 10 respondents reported they had accessed them. We did not include these results to maintain the confidentiality of those respondents.

Comparison to similar organisations

We compared data from After the fires and Answering the call with FRV respondent data from our survey. We based our survey on these studies so we could compare FRV's results with those of similar organisations across Australia. Four questions relating to organisational culture were identical across the 3 datasets, and one additional question was the same in our survey and After the fires. 

As Figure 2 shows, FRV performs better than the combined average for other state and territory fire and rescue organisations on 4 of 5 organisational culture indicators. 

Organisational actions to support mental health and wellbeing

FRV's executive leadership team has demonstrated a commitment to staff mental health and wellbeing by investing in mental health support. This includes the ongoing provision of the range of mental health support we discuss earlier in this section. 

In addition, Figure 3 outlines recent organisational initiatives the executive team has led to support staff wellbeing. 

Source: VAGO.

Beyond Blue's 10 actions for a mental health strategy

The good practice framework outlines 10 actions an organisation can take to strategically support staff mental health:

1. develop an overarching strategy based on an integrated approach to mental health

2. involve frontline workers in planning, developing, implementing and evaluating the strategy 

3. involve representatives from other areas of the organisation in developing the strategy

4. take a whole-of-career approach to mental wellbeing

5. include mental health in its regular risk assessments

6. identify a champion or sponsor from senior management to be responsible for the strategy and regularly reporting against it

7. ensure multiple people have organisational knowledge of the mental health strategy so momentum in supporting staff to maintain their mental health is not lost when staff move into other roles or leave the organisation

8. regularly evaluate the initiatives it implements under the strategy 

9. consider the possible benefits of external research collaborations or partnerships

10. consider how it can include families and other social support in mental health support.

No mental health strategy

In the absence of a mental health and wellbeing strategy, FRV uses 13 separate internal and external policies, strategies and other documents, including: 

• Fire Rescue Victoria Strategic Plan 2022–2032
• Health Safety and Wellbeing 36-month horizon outlook
• Work Health Safety Policy. 

A single, cohesive mental health strategy would help FRV to be more strategic in how it supports staff mental health in the short and long term. Without a mental health and wellbeing strategy it is difficult for FRV to realise the good practice framework's recommended actions. 

In April 2024 FRV recruited a director, health and wellbeing. The director is developing a health, safety and wellbeing strategy that covers mental health, but FRV does not currently have an expected completion date for this. 

Good-practice benchmark for data analysis

The good practice framework recommends an organisation uses a systematic approach to manage workplace risks that affect, or could affect, staff mental health.

It recommends analysing available data to identify and mitigate risks. 

Available data

FRV collects, analyses and reports some information on staff mental health and wellbeing. 

It uses this data to inform some decisions and identify staff who have a higher risk of poor mental health. 

2024 VAGO survey

Our survey has provided the first comprehensive, population-level mental health and wellbeing dataset on FRV staff. It includes data on:

• staff mental health and wellbeing
• staff awareness and experiences of the mental health and wellbeing support FRV offers. 

FRV can use this data: 

• to understand its staff's current mental health and wellbeing
• as a baseline to inform future monitoring and evaluation.

Using data

FRV used data from mental injury workers compensation claims to support its decision to restructure its health, safety and wellbeing division in 2021.

In 2021 and 2023 it used training participation data to support its decision to continue running mental health literacy training programs. 

Aside from these 2 examples, FRV has not used available data to inform its decisions on its mental health support.

Need for more data analysis

FRV does not have reliable data on how many staff have used its mental health services. 

As we discuss in Section 3, FRV keeps manual records of staff training attendance. It does not accurately record the number of current staff who have completed mandatory and voluntary training.

FRV's incomplete and inaccurate data and an absence of trend analysis and reporting make it difficult for it to: 

• get an accurate, holistic picture of staff mental health and wellbeing
• assess if its mental health services and initiatives are being used and are effective.

Good-practice benchmark for managing psychosocial hazards

The good practice framework recommends that an organisation identifies, documents, assesses and controls psychosocial hazards. 

The framework says that 'psychosocial factors', or hazards, include 'the way work is carried out (deadlines, workload, work methods) and the context in which work occurs (including relationships and interactions with managers and supervisors, colleagues and co-workers, and members of the community)'.

FRV's psychological health and safety desktop review

FRV did a psychological health and safety desktop review between August 2023 and February 2024. 

The review found that FRV was not identifying, documenting and assessing psychosocial hazards and their risks. 

The review informed a report that had 8 recommendations. The deputy commissioner approved the report, including its recommendations, in April 2024. 

The recommendations aim to improve how FRV identifies, documents and assesses psychosocial hazards and their risks by:

1. prioritising projects, systems and initiatives in the ‘prevent harm’ category

2. developing a psychological health and safety systems evaluation strategy

3. engaging an external consultant to objectively review the strategy

4. setting up a steering committee and project team

5. finalising a project delivery plan

6. conducting phase 2 of collecting quantitative and qualitative data with key accountability holders and stakeholders

7. incorporating psychological health and safety terminology into data collection

8. doing a baseline psychosocial risk assessment survey and running supplementary focus groups.

FRV has made some early progress towards recommendations 3 and 5. It does not have an agreed plan or timeline to implement all 8 recommendations yet. 

Using data to assess psychosocial hazards

FRV could improve how it assesses psychosocial hazards by collecting and analysing data from existing sources, such as its: 

• OHS management system FRVSafe
• EAP
• in-house psychology services
• peer support program
• wellbeing checks
• wellness musters
• chaplains.

These sources either provide or could provide a range of data about psychosocial hazards, including data about bullying, harassment, discrimination, job demands, physical safety, organisational culture and work-life balance.

Survey results about FRV's psychosocial climate

Our survey asked multiple questions about the psychosocial climate at FRV, including questions about:

• bullying
• discrimination
• harassment.

Our survey found:

• 21.2 per cent of respondents reported being bullied at work over the last 12 months
• 22.3 per cent of respondents reported personally experiencing discrimination at work over the last 12 months
• 20.6 per cent of respondents reported that they had been harassed or assaulted verbally in the course of their work, 'sometimes', 'often' or 'very often'.

Good practice for monitoring exposure to trauma

According to the good practice framework, cumulative exposure to trauma can contribute to a person developing a mental health condition. Some people also develop a condition after being exposed to a single traumatic incident. 

Regular screening helps to proactively detect mental health risks. Tracking staff who are exposed to trauma can help an organisation target intervention strategies before staff mental health deteriorates.

Current responses to trauma

FRV activates its peer support network every time a staff member is exposed to a potentially traumatic event. A peer support officer then follows up and supports affected staff. 

Not tracking trauma exposure

FRV does not track the number and types of potentially traumatic events staff are exposed to. If FRV collected this information it could: 

• start monitoring staff mental health and wellbeing over time
• take appropriate preventative action 
• connect staff to necessary support.

FRV is currently participating in research led by the Australasian Fire and Emergency Services Authorities Council. This research aims to identify best-practice trauma tracking systems. 

FRV intends to use the outcomes of the research to develop its own trauma tracking system.

FRV staff's exposure to trauma

Our survey data shows that many FRV staff have experienced a potentially traumatic event or events during their work at FRV.

We asked if staff had experienced a stressful event or series of events either at work or away from work that deeply affected them. Eighty-four per cent of respondents answered 'yes' to this question. Of these respondents, 74 per cent said that the stressful event or series of events was 'at FRV'. 

We also asked how often staff are put in emotionally disturbing situations. Over 19 per cent of respondents said 'often' or 'always'. 

FRV staff reported similar rates of high and very high psychological distress, low mental wellbeing, diagnosed depression, anxiety and PTSD as respondents from Answering the call.

Good practice for mental health screening

The good practice framework says screening applicants can help an organisation promote the mental health of its staff. It recommends that an organisation should: 

• consider including mental health assessments as part of its broader recruitment process
• engage psychologists or suitably qualified and accredited providers to do psychological screening assessments
• use these psychological assessments, in conjunction with other screening and assessment methods, to determine an applicant's suitability for the role.

Firefighter recruitment process

FRV recruits new firefighters based on:

• physical aptitude testing
• interviews
• a written assessment
• a health screening, which it refers to as a pre-employment medical assessment.

During a health screening a doctor assesses the applicant's fitness for firefighting duties against the Australasian Fire Authorities Council Guidelines for Health and Fitness Monitoring for Australasian Fire and Emergency Service Workers (2002) (the guidelines).

Not documenting the process

FRV has a duty of care to both its staff and the community to ensure firefighters are medically, physically and psychologically capable of performing their required duties. FRV fulfils this duty by screening firefighter applicants.

FRV has not documented its health screening process from end to end. It has not clearly outlined the: 

• purpose, steps and requirements of the process
• roles and responsibilities of staff who lead each step of the process.

Instead, knowledge of the process is: 

• held by a limited number of staff 
• documented in several separate documents, which cover discrete parts of the process.

This increases the risk that staff involved in the process: 

• may not follow it consistently
• may be unclear about some steps. 

Our understanding of FRV's process

FRV's screening process, as it relates to mental health, involves:

• the applicant completing a health questionnaire and doing a range of physical tests with a doctor
• the doctor and the applicant discussing any information that indicates the applicant has, or may have, a mental health condition.

If the doctor believes the applicant has, or may have, a mental health condition, they write a letter to the applicant’s treating practitioner to request further information. The letter describes the inherent requirements of the firefighter role and asks the practitioner if they believe: 

• the applicant’s condition would impact their ability to perform the role
• the demands of the role would impact the applicant's condition.

The screening doctor prepares a report about the applicant's fitness for the firefighter role based on the treating practitioner's response.

FRV then makes the final decision on whether or not the applicant is medically fit for the role.

The guidelines 

In 2002 the then Australasian Fire Authorities Council published the guidelines to protect firefighters from injuries and illness while maintaining their confidentiality.

The guidelines:

• explain how 18 different kinds of medical conditions, including 'psychiatric disorders', may impact a person's fitness to be a firefighter
• provide a 'model medical questionnaire'
• note that the guidelines may be reviewed and updated in the future.

FRV told us that the guidelines are outdated because they: 

• do not currently reflect the role of a contemporary firefighter
• have limited information about:
  • how different mental illnesses may impact a firefighter’s ability to do their job
  • the impact that firefighting may have on a person's mental health.

New health model

The Victorian Government set an action for FRV to develop and implement a contemporary health model by June 2023 in its Year Two to Five Fire Services Reform Implementation Plan.

Specifically, the plan said that FRV needs to develop a health model that ‘establishes state-wide comprehensive organisational health standards, policies and support mechanisms’ so it can appropriately support its staff throughout Victoria.

FRV acquitted this action in October 2023. But it has neither completed all the 'health standards, policies and support mechanisms' nor has it set a completion date for the outstanding items.

FRV told us that its health model will include a new medical standard. It has drafted but not approved the new standard. FRV intends to use the new medical standard instead of the guidelines in its health screening process.

Questionnaire before April 2024

FRV uses a questionnaire during its screening process to detect mental health conditions. The questionnaire uses the Depression, Anxiety and Stress Scale 21 (DASS-21), which rates an applicant’s level of depression, anxiety and stress symptoms based on their responses to a set of statements.

The guidelines' 'model medical questionnaire' includes 3 questions specifically about an applicant’s mental health. Before April 2024 FRV’s questionnaire did not explicitly ask applicants about their mental health but had 4 questions where an applicant could disclose a mental health condition:

• 'Are you currently attending a health professional for any illness or injury?'
• 'Have you taken any medication, drugs, vitamins or supplements in the last month?'
• 'During the past year, approximately how many days were you away from school or work because of illness? Reason(s)?'
• 'Have you ever had any other serious injury, illness, operations, or been in hospital for any reason?'

Our review of FRV's 2023 questionnaires

We reviewed the questionnaires FRV used in its March and November 2023 recruitment rounds. None of the 269 applicants recorded DASS-21 ratings above ‘mild’. Consequently, the screening doctors did not suspect a mental health condition. 

However, 10 applicants did disclose other information that indicated they may have had a mental health condition. In particular: 

• all 10 applicants said they took medication related to mental health in the month before they applied for the role
• one applicant additionally disclosed that they were seeing a mental health professional.

By not explicitly asking about mental health, FRV could not ensure its screening process identified all applicants with current or prior mental health conditions. 

Improving the questionnaire

In April 2024 FRV revised its questionnaire to explicitly ask about mental health. The questionnaire now also asks: 

• 'Have you ever experienced or been diagnosed with a mental health condition or psychiatric illness?'
• 'Have you ever sought psychological treatment or support from a psychologist, psychiatrist, counsellor, GP or other mental health professional?'
• 'Do you experience claustrophobia?'

Improving guidance and processes for screening doctors

FRV expects the screening doctor to always seek further information from an applicant's treating practitioner if they identify a potential mental health condition. 

However, FRV's training material for screening doctors says they ‘may’ need to obtain a treating practitioner's report to complete an applicant’s psychiatric assessment.

As a result, screening doctors may not always follow FRV's intended process.

Before April 2024 FRV did not give screening doctors a template to request further information from treating practitioners. This led to inconsistencies in the information that screening doctors gave to and requested from practitioners. 

For example, not all letters from the screening doctor to the treating practitioner described the inherent requirements of the firefighter role. This left treating practitioners to do their own research or provide advice without the necessary occupational context. 

FRV developed a letter template for screening doctors to start using in the April 2024 recruitment round.

FRV's process for the DASS-21 is also unclear for screening doctors. If an applicant is rated 'moderate', 'severe' or 'extremely severe' on the DASS-21 but has not seen a treating practitioner, FRV's process does not specify if or how the screening doctor should seek additional information to assess their fitness for the role.